Posted tagged ‘lactose’

Lactose intolerance

March 16, 2009

Poornima asked about lactose intolerance and supplements: “Does a lactose intolerant child need calcium supplements? If so, which ones? I thought the soy milk is calcium fortified- but I do understand that there are brands that are not.”

I looked at labels at the grocery store today, and the common brands of soy milk are calcium and vitamin D fortified—they have essentially the same content of these nutrients as cow’s milk. There are probably smaller brands that are not fortified, so it’s best to check the label.

Lactose intolerance is common in adults, especially among African- and Asian-Americans. However, it is virtually non-existant in babies. Human breast milk is loaded with lactose, and our babies are very good at digesting this natural sugar. Their guts are loaded up with lactase, the enzyme needed for lactose digestion. As children get older, many start to lose this lactase activity and may begin to have trouble digesting lactose. When that happens, symptoms like bloating, abdominal pain, and gassy diarrhea can occur. Because many adults are lactose intolerant, baby formula companies take advantage of this fear to sell special lactose-reduced formulas. Don’t fall for this—the chance of baby being lactose intolerant is probably one in a million.

Diagnosing lactose intolerance is best done by trial and error. If you think your older child has this, take her off milk for a week or so. Then on a day without other big plans, give her a nice big milkshake. Yum! If an hour or so later she’s in the bathroom miserable, she’s probably lactose intolerant. Though there are medical tests to confirm this, they’re difficult to do in children and rarely necessary.

Treatment consists mainly of avoiding lactose sources—that is, all dairy products. Items that are cooked or heated will have less lactose than ordinary milk. Everyone who is lactose intolerant has a “threshold level,” beyond which symptoms will occur. This threshold will be very low for some people (say, only ½ a slice of cheese pizza), while others might be able to tolerate a bit more (maybe one small glass of milk, but no more.) Experiment to find out what the threshold is so you can avoid going over the limit.

There are supplements sold to help with lactose intolerance, usually enzymes that are said to be able to replace the natural effect of lactase. Some people find these effective, but most do not. Almost all natural lactase activity occurs far into the small intestine, and most of any swallowed enzyme is likely broken down long before the food makes it that far down. Still, lactase supplements are safe and feel free to use them if they seem to help.

In a typical American diet, diary products are the major source of both calcium and vitamin D. For infants, milk and dairy are also a significant source of protein and calories. If your child can’t tolerate dairy, you should discuss her individual needs with her pediatrician to make sure that she’s getting enough of these nutrients.

Organic infant formula? One brand is a bad idea

August 10, 2008

As reported by the New York Times, parents thinking that Similac Organic Infant Formula is healthier than conventional formulas are in for a surprise. The company that makes it, Ross, decided to use cane sugar as a sweetener. This makes Similac Organic taste sweeter than other infant formulas, and much sweeter than human milk. It’s riskier for a baby’s teeth, and is very likely to lead to over-eating. Worse still, it may help imprint a desire for sweeter foods starting at a very young age.

As discussed in this post, I’m not a proponent of organic foods. They’re more expensive, and I’m not convinced that they’re healthier or better for children. In the case of this particular infant formula, parents are paying about 30% more for a product that’s very likely to be less healthful than non-organic alternatives. You can’t assume that organic = more healthful.